I am not sure I ever achieved sufficient detachment from my family, hence I can't cut toenails. Lovely piece, as usual it made me well up. Feeling sniffy just typing this.
I would agree with medical educators, it is very much a skill you can hone into. Some people had to dissociate earlier due to difficult circumstances. I really enjoyed that
Yeah, one hundred percent. I really struggled with surgery as a medical student because I could almost feel the pain myself, even though I wasn’t the one being cut. For most of medical school, I assumed that meant surgery simply wasn’t for me, and I built my plans around infectious diseases instead.
COVID changed that. With so much illness and death around, I had to learn how to create enough emotional distance to keep functioning without becoming numb to it all.
Something shifted in me then. Maybe I became more resilient, maybe just more capable of carrying difficult things. Either way, surgery stopped feeling impossible.
Thank you for this excellent piece of writing, Gabriel. I can picture you so well as a child now.
As you know, my daughter was very interested in being a surgeon until she joined the disection club and decided there was 'something wrong with those people who love cutting things up.' I think some people simply aren't suited to the role.
I love the way you tell your story about coming back to the UK. It feels so familiar, having made a similar transition at the same age. I was ten when I first arrived from a life in African countries, and I couldn't quite believe people lived here (it was January, so bitterly cold in a way I had never experienced).
The change in freedom felt the same for me too. I used to walk the dusty road in front of our house in bare feet, run outside to play in the rain, and rarely saw my parents because I was hanging out with the neighbourhood children.
It must have been such a wrench ending up at boarding school after that. I didn't go away to school, but I think the teen years can be pretty cruel for many who have enjoyed the sunny uplands of primary years.
I love the way you describe your African childhood here. It’s so evocative. I also think, nowadays, kids would be able to keep in touch with friends online, which reminds me that screens aren’t all bad, are they? Thanks so much for engaging so deeply with my piece.
This post got me thinking quite a lot. I have never found it difficult to remain clinically detached. I thought that this was just my personality. My parents were good in many ways, but never really demonstrated much affection especially as my brother and I got older. My mother's main priority has always been work and it still is now, in her eighties!
My parents were completely different to my wife's. Thier main priority was family and the closeness that comes with that.
My brother and I were also encouraged to soldier on whatever.
Looks as if, for me, my detachment, could be nature, nurture or a bit of both.
This is a truly fascinating piece. It cuts against what I'd imagine is the "correct" move now... full presence, feeling things fully, all that. But so interesting that this elaborate displacement technique has been so functionally useful.
I can imagine. I thought after I posted I was so interested by your description I rather forgot the compassion. It sounds like some very difficult times.
I read this post with great interest, Gabriel, how you learnt the art of emotional containment at an early age. For various reasons, my childhood was an emotionally barren one, but maybe it set me up for representing someone in the family court. To be their mouthpiece without passing judgment. People used to ask me (and still do!) how I managed to represent certain clients who had serious allegations against them and I often used the example of a surgeon to explain why. I would say when an injured person is brought to a hospital for emergency surgery, that surgeon does not pass judgment on what that person might be like, or what they might have done. Instead, they get on with their job and try and save them. Likewise, I got on with my job, represented them as the best I could and put their case before the court.🍒
This is fascinating. I’m so sorry your childhood felt that way. But how wonderful for those who have had you advocating for them. Thanks for telling me this.
This resonated deeply. Although not a surgeon, I practiced 'clinical detachment' as a social worker for self-protections daily almost in the same moment as emotional tolerance. I think many of us learn some way this skill long before we have a name for it, it certainly didn't come from university training. We rehearse loss, disappointment, rejection, or separation in an attempt to soften the end of the day when we return to our families. I really enjoyed reading this, the first paragraph hooked me in.
Thanks. I’m so touched. The work you do is so demanding, I’m not at all surprised you need special mechanisms for coping. Thanks for your engagement with my writing. It means a lot.
I've worked in a hospital most of my career so definitely have shared a bit gallows humour which created the clinical distance about it too with staff. Yes definitely coping mechanism. Thank for writing this, really appreciate it.
I don’t think your father’s advice is unhealthy. It sounds like a form of radical acceptance to me. Allowing all the feelings to be there to be able to let them go, be present, and do what you need to do without overwhelm. Love it.
This is such a great and insightful piece. I felt anxious reading it as I have a young son and the thought of sending him away to board is so horrifying, I almost have to sit in those awful feelings to make them go away. Which is where I resonate with what you describe so viscerally. I love how you describe it. We wouldn’t be our present selves without our pasts but that’s where we learn not to repeat patterns / mistakes that didn’t serve us. I can’t wait to read all your other articles (and of course your book!)
Thank you Adele. From what I understand, boarding school is very different now to how it was then. And there are other ways of handling difficult feelings than the one I inherited. Thank you so much for your engagement in my writing. It means the world to me.
Yes I am sure there are brilliant boarding schools and amazing teachers attached to them. And good parents always do their best for their children. I find it fascinating how we use strategies from our past that enable us to cope, almost without realizing that’s what it is. Thank you for your response and for your writing
The moment when crying at home began to feel almost like the performance, while the coldness at school became the more solid reality, really stayed with me. It was striking to see something learned as a child for getting through separation return years later in the operating room. I also appreciated that you didn’t present that detachment as entirely good or bad. It helped you survive, and later helped you do the work, but the cost of learning it is still there.
I’m hooked and can’t wait to read everything else on your substack! My husband and I were just discussing this very thing as he had quite a traumatic childhood in which his father never acknowledged pain—his own or anyone else’s. It’s been something to work through in marriage & parenting & the underbelly of this is clear….but: my husband simply doesn’t panic, ever. And we decided that while he could have benefitted from some empathy & compassion, it produced a strange security & confidence in his ability to endure literally anything. Learning interdependence and nurture has been quite a feat, but then I’m long on those qualities & that’s helped. I benefitted from his “get it done” mentality. We’ve stuck it out & gave our 4 kids a pretty good combo.
Thanks so much for being in touch and for this message. My husband also provides a good foil to me and we hope we cover most bases with the kids. Please do let me know what you think of my substack. Best wishes
What you went through sounds terrifying. It is interesting how it is this bit of adversity that you feel connected to at times in the operating room, and that it was a strategy that your father shared with you out of his shared experience and compassion that got you through the challenges and stays with you today.
It was so far from what I expected. Taking away from it though, I hope to help my daughter reflect on the challenges she’s faced and the resiliency she found from them. Of course they are not the same as yours, but I think it’s not the specific nature of your troubled time, but the way you worked it out that impacted you. That’s how I read it. Thanks so much for sharing!
Holy Moly (I thought I'd drop my American expression here, since you miss us so much! come visit!), but that is some serious trauma induced coping mechanism turned superpower!
Lovely piece and I so enjoyed reading it.
It made me think about my own dysfunctions. I will have to stew on that for a while...
I grew up moving around a lot, and spent a year in Japan, without knowing a word of Japanese. I have very similar fond memories of friendship and carefree girlhood during that time.
I am not sure I ever achieved sufficient detachment from my family, hence I can't cut toenails. Lovely piece, as usual it made me well up. Feeling sniffy just typing this.
I would agree with medical educators, it is very much a skill you can hone into. Some people had to dissociate earlier due to difficult circumstances. I really enjoyed that
Was that your experience, Bear?
Yeah, one hundred percent. I really struggled with surgery as a medical student because I could almost feel the pain myself, even though I wasn’t the one being cut. For most of medical school, I assumed that meant surgery simply wasn’t for me, and I built my plans around infectious diseases instead.
COVID changed that. With so much illness and death around, I had to learn how to create enough emotional distance to keep functioning without becoming numb to it all.
Something shifted in me then. Maybe I became more resilient, maybe just more capable of carrying difficult things. Either way, surgery stopped feeling impossible.
That’s so interesting. Thanks for sharing.
Thank you for this excellent piece of writing, Gabriel. I can picture you so well as a child now.
As you know, my daughter was very interested in being a surgeon until she joined the disection club and decided there was 'something wrong with those people who love cutting things up.' I think some people simply aren't suited to the role.
I love the way you tell your story about coming back to the UK. It feels so familiar, having made a similar transition at the same age. I was ten when I first arrived from a life in African countries, and I couldn't quite believe people lived here (it was January, so bitterly cold in a way I had never experienced).
The change in freedom felt the same for me too. I used to walk the dusty road in front of our house in bare feet, run outside to play in the rain, and rarely saw my parents because I was hanging out with the neighbourhood children.
It must have been such a wrench ending up at boarding school after that. I didn't go away to school, but I think the teen years can be pretty cruel for many who have enjoyed the sunny uplands of primary years.
I love the way you describe your African childhood here. It’s so evocative. I also think, nowadays, kids would be able to keep in touch with friends online, which reminds me that screens aren’t all bad, are they? Thanks so much for engaging so deeply with my piece.
This post got me thinking quite a lot. I have never found it difficult to remain clinically detached. I thought that this was just my personality. My parents were good in many ways, but never really demonstrated much affection especially as my brother and I got older. My mother's main priority has always been work and it still is now, in her eighties!
My parents were completely different to my wife's. Thier main priority was family and the closeness that comes with that.
My brother and I were also encouraged to soldier on whatever.
Looks as if, for me, my detachment, could be nature, nurture or a bit of both.
Thanks so much for sharing that. It’s really interesting to me.
This is a truly fascinating piece. It cuts against what I'd imagine is the "correct" move now... full presence, feeling things fully, all that. But so interesting that this elaborate displacement technique has been so functionally useful.
Thanks Will. Useful in some areas of life, less so in others. Thanks so much for commenting.
I can imagine. I thought after I posted I was so interested by your description I rather forgot the compassion. It sounds like some very difficult times.
That’s kind Will. Thanks, from a tough-skinned old boot.
I read this post with great interest, Gabriel, how you learnt the art of emotional containment at an early age. For various reasons, my childhood was an emotionally barren one, but maybe it set me up for representing someone in the family court. To be their mouthpiece without passing judgment. People used to ask me (and still do!) how I managed to represent certain clients who had serious allegations against them and I often used the example of a surgeon to explain why. I would say when an injured person is brought to a hospital for emergency surgery, that surgeon does not pass judgment on what that person might be like, or what they might have done. Instead, they get on with their job and try and save them. Likewise, I got on with my job, represented them as the best I could and put their case before the court.🍒
This is fascinating. I’m so sorry your childhood felt that way. But how wonderful for those who have had you advocating for them. Thanks for telling me this.
Powerful read thanks for sharing
Thank you. There’s nothing I love more than hearing my writing has resonated with someone.
This resonated deeply. Although not a surgeon, I practiced 'clinical detachment' as a social worker for self-protections daily almost in the same moment as emotional tolerance. I think many of us learn some way this skill long before we have a name for it, it certainly didn't come from university training. We rehearse loss, disappointment, rejection, or separation in an attempt to soften the end of the day when we return to our families. I really enjoyed reading this, the first paragraph hooked me in.
Thanks. I’m so touched. The work you do is so demanding, I’m not at all surprised you need special mechanisms for coping. Thanks for your engagement with my writing. It means a lot.
I've worked in a hospital most of my career so definitely have shared a bit gallows humour which created the clinical distance about it too with staff. Yes definitely coping mechanism. Thank for writing this, really appreciate it.
I appreciate you for writing about this.
Thank you so much for reading it. And I’m so glad you liked it.
I don’t think your father’s advice is unhealthy. It sounds like a form of radical acceptance to me. Allowing all the feelings to be there to be able to let them go, be present, and do what you need to do without overwhelm. Love it.
Thanks. I like that take.
Ouf! My heart. You buried the lead, doctor. And here’s me romanticizing English boarding schools as one long sleepover. 🤦🏻♀️
Thank you.
This is such a great and insightful piece. I felt anxious reading it as I have a young son and the thought of sending him away to board is so horrifying, I almost have to sit in those awful feelings to make them go away. Which is where I resonate with what you describe so viscerally. I love how you describe it. We wouldn’t be our present selves without our pasts but that’s where we learn not to repeat patterns / mistakes that didn’t serve us. I can’t wait to read all your other articles (and of course your book!)
Thank you Adele. From what I understand, boarding school is very different now to how it was then. And there are other ways of handling difficult feelings than the one I inherited. Thank you so much for your engagement in my writing. It means the world to me.
Yes I am sure there are brilliant boarding schools and amazing teachers attached to them. And good parents always do their best for their children. I find it fascinating how we use strategies from our past that enable us to cope, almost without realizing that’s what it is. Thank you for your response and for your writing
The moment when crying at home began to feel almost like the performance, while the coldness at school became the more solid reality, really stayed with me. It was striking to see something learned as a child for getting through separation return years later in the operating room. I also appreciated that you didn’t present that detachment as entirely good or bad. It helped you survive, and later helped you do the work, but the cost of learning it is still there.
Thank you. This means a lot to me.
I’m hooked and can’t wait to read everything else on your substack! My husband and I were just discussing this very thing as he had quite a traumatic childhood in which his father never acknowledged pain—his own or anyone else’s. It’s been something to work through in marriage & parenting & the underbelly of this is clear….but: my husband simply doesn’t panic, ever. And we decided that while he could have benefitted from some empathy & compassion, it produced a strange security & confidence in his ability to endure literally anything. Learning interdependence and nurture has been quite a feat, but then I’m long on those qualities & that’s helped. I benefitted from his “get it done” mentality. We’ve stuck it out & gave our 4 kids a pretty good combo.
Thanks so much for being in touch and for this message. My husband also provides a good foil to me and we hope we cover most bases with the kids. Please do let me know what you think of my substack. Best wishes
What you went through sounds terrifying. It is interesting how it is this bit of adversity that you feel connected to at times in the operating room, and that it was a strategy that your father shared with you out of his shared experience and compassion that got you through the challenges and stays with you today.
It was so far from what I expected. Taking away from it though, I hope to help my daughter reflect on the challenges she’s faced and the resiliency she found from them. Of course they are not the same as yours, but I think it’s not the specific nature of your troubled time, but the way you worked it out that impacted you. That’s how I read it. Thanks so much for sharing!
Thank you so much. I guess I’m speculating about what led to what, but I think there was a connection. Your daughter is lucky to have you.
Holy Moly (I thought I'd drop my American expression here, since you miss us so much! come visit!), but that is some serious trauma induced coping mechanism turned superpower!
Lovely piece and I so enjoyed reading it.
It made me think about my own dysfunctions. I will have to stew on that for a while...
I grew up moving around a lot, and spent a year in Japan, without knowing a word of Japanese. I have very similar fond memories of friendship and carefree girlhood during that time.
I love this reply. Thank you. And please come back to me with more thoughts when you’ve had a stew.